Job Purpose or Scope: Monitors and documents credentialing of transportation providers, drivers and vehicles for NEMT brokerage line. Coordinates quarterly, semi-annual and annual credentialing and qualification update requests and document submissions.
- Reviews and verifies the credentials of transportation providers on regular and ongoing basis to ensure they continue to meet contractual and regulatory requirements
- Works closely with location staff and provider to explain and clarify credentialing requirements and submission questions.
- Assists and presents credentialing education sessions for locations and providers.
- Collects, analyzes and reports on status application in progress and completion of compliance related tasks, including exclusion screenings, training and vehicle/facility inspections.
- Researches, collects and reports on local regulatory changes impacting credentialing requirements.
- Coordinates and reviews quarterly, semi-annual and annual credentialing and qualification update requests, audits and documentation submissions.
- Coordinates, completes and documents exclusion screenings of providers and First Transit staff supporting brokerage locations.
- Works closely with start-up teams to recruit, educate and training new and/or expanding NEMT provider networks.
- Provides analytical support including data entry, analysis and graphical representation of data using Microsoft Excel and editing and writing reports.
- Conducts business related research and reporting by identifying, and gathering relevant information from a variety of sources as directed by the Director of Healthcare Compliance.
- Provide guidance and assistance to NEMT network regarding BEP/WBE/MBE certification.
- Other credentialing, administrative, support and compliance duties as assigned.
Describe level of decision making and list examples of common decisions made: Lead process for transportation provider credentialing, determining if information submitted by vendor fulfills minimum participation standards. Coordinate regular and repeated documentation requests for auditing and ongoing monitoring. Assist in exclusion screening and deciding it potential hits would exclude individual and/or entity from participating in relevant work. Ability to work with each department to ensure project timelines are met.
Minimum Education & Certifications Required:
- 2 year associates degree or equivalate work experience required; 4 year degree preferred
- Advanced knowledge of multi-task computer operation in a Windows environment. In particular Windows based PC systems with an emphasis on Excel proficiency
- Ability to proficiently operate a computer with a speed of no less than 35 keystrokes per minute
Experience & Skills Required:
- Highly organized with attention to detail
- Ability to effectively prioritize multiple tasks and deadlines, with flexibility and capacity to identify and administer competing operational priorities in a changing environment with creativity and resourcefulness
- Ability to define issue, interpret data and define options
- Excellent verbal, interpersonal, judgment and problem-solving abilities
- Ability to undertake assignments with minimum supervision and direction
- Ability to work effectively in a team environment and interact diplomatically with a wide variety of people
- Ability to accurately conduct primary and secondary research
- Awareness of change and the capacity to develop additional skills as required
- Ability to communicate clearly in the English language
- Meets all Qualifications and Job Requirements and understands all Role and Responsibilities
- Professional corporate experience and professional demeanor
- Transportation or healthcare experience preferred, but not required
- Experience with auditing or documentation verification preferred, but not required
Physical Requirements & Working Conditions (include amount of travel): Incumbent must be able to move about the office and between floors; utilize standard office equipment; access filing system/cabinets; and communicate effectively and efficiently in person or by telephone.
Ability to sit in front of and operate a video display terminal for extended periods of time.
Must be able to work proactively in a high-stress, multi-task and fast-paced environment
Ability to travel up to 5% of the time
List any additional measures applicable to this position (Revenue, Headcount, # of buses; Budgets $ etc.):
Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. This job description reflects management’s assignment of essential functions, it does not prescribe or restrict the tasks that may be assigned.